Provider Demographics
NPI:1093812117
Name:ECKART, PATRICIA CAROL (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:CAROL
Last Name:ECKART
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 EVERGREEN DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1059
Mailing Address - Country:US
Mailing Address - Phone:610-579-3555
Mailing Address - Fax:610-579-3566
Practice Address - Street 1:300 EVERGREEN DR
Practice Address - Street 2:SUITE 310
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1059
Practice Address - Country:US
Practice Address - Phone:610-579-3555
Practice Address - Fax:610-579-3566
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004533-B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA036725LGGMedicare PIN
PAPO3570Medicare UPIN